The near miss with a patient that still haunts me

I CAME across a report this week that brought memories I’d sooner forget flooding back.

According to a survey, more than half of junior doctors have had an accident or near-miss on the way home after a night shift.

Even more worrying is how tiredness affects judgment.

As a recently qualified doctor, I was covering several wards. Around midnight, I got a call to say that a patient’s oxygen levels were low. I was frantically busy, so told them to ‘sit her up and give her a bit of oxygen’.

An hour later, the ward called again. I went to see the patient, an elderly woman who was breathing heavily.

‘She doesn’t look right and her stomach hurts,’ a nurse told me.

Another ward beeped me. A patient was having a heart attack, so I rushed off — but popped back later to check on her again. I was told she’d been constipated, so I prescribed a laxative.

Four hours later, after running back and forth between wards, increasingly exhausted, I realised she was dying in front of me. But why, my befuddled brain asked, she’s only constipated?

She wasn’t: she had a blood clot on the lung. It’s one of the most basic medical emergencies and I’d missed the telltale symptoms. Too tired to think straight, I’d failed to properly assess her. The patient was sent to intensive care. Thankfully, she survived.

The 1993 European Working Time Directive, which said that no one should work more than 48 hours a week, was supposed to transform the gruelling regime that young doctors traditionally had to endure.

As the new survey shows, little has changed. Doctors work the same long hours — and, as I know too well, the consequences can be catastrophic.